糖尿病神经病变病人末梢感觉定量检查方法的探讨与临床应用

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1、糖尿病神经病变病人末梢感觉定量检查方法的探讨与临床应用汤正义张炜张莲珍陈宇红王卫庆刘建民洪洁毛羽丰赵*桔罗邦尧宁光【摘要】目的探讨糖尿病(DM)病人末梢感觉定量检测方法(QST)及其在临床应用的价值.方法采用计算机辅助感觉定量检査仪，检测120名正常人与92例DM病人四肢末梢的冷、热感觉，冷、热痛觉和振动觉等5项。结果检测结果，临床常规检査有糖尿病神经病变(DPN)病人的检测数值100%异常，常规检査无神经病变的，与同时采用四肢末梢5项检测的数值比较，差异无显著意义(才=0・922,P=0.631)；DM病

2、人QST检测结果与正常人数值比较，温度觉与振动觉明显祓退‘QST检査发现的DM末梢感觉异常人数比临床常规检査发现的明显增多(才=10.985,P=0.001),这两种检査的异常人数又都与DM病程相关。结论DM病人QST可选择足部作常规检査；计算机辅助感觉定量检测是早期发现DPN的良好指标。【关键词】糖尿病神经病变'感觉定就检査Theselectionofquantitativesensorytestmethodsinpatientswithdiabeticperipheralneuropathyandits

3、clinicalapplicationTANGZheng-yi•ZHANGWei9ZHANGLian-zhentetal.RutjinHospital9affiliatedtoShanghaiSecondMedicalUniversitytShanghaiClinicalCenterforEndocrinologyandMetabolicDiseases>Shanghai200025♦China[Abstract]ObjectiveTheextremitysensesofdiabeticpatientsan

4、dnormalcontrolswerequan*titativelytestedtoobservethedifference,todeterminetheperipheralneuropathy,andtosimplifytheexaminingcoursewithoutlossofimportantinformation.MethodsThethresholdsofcoolsense(CS)twarmsense(WS)*coldpain*heatpain,andvibrationsense(VS)were

5、testedamong120normalpersonsand92type2diabeticpatientswithcomputer-assistedsensoryevaluationIVdevice.ResultsTheabnormalitiesfoundindiabeticpatientswhotookupfourextremitiesexaminationforall5thresholdsvsthosewhoacceptedtestsonlyforCS,WS,VSthresholdsonfeetwe

6、reall100%intientswithclinicalneuropathyandnodifferenceinthosewithoutclinicalneuropathy(才=0.922♦P=0.631).Comparedwithnormalpeople*diabeticpatientextremitysenseswerealldecreased*evenwithorwithoutclinicalneuropathy.Thenumberofthepatientswithclinicaldiabeticpe

7、ripheralneuropathywaslessthanbyQST(才=10.985♦P=0.001)•buttheyallassociatedwithdiabeticduration(r=0.978.P=0.000vsr=0.973・P=0.000).ConclusionComputer-assistedquantitativesensoryevaluationisagoodmethodtofindearlyDPN.Thetestcoursecouldbesimplifiedtotestfeettofi

8、ndDPNingeneraL【Keywords]Diabeticneuropathies;Sensationquantityexamination糖尿病周围神经病变(DPN)的检査项目包括神经传导速度和末梢感觉定量检査(quantitativesensorytest,QST)Cl]0末梢感觉借助简单工具检测，一般只能作描述性报告。现在可以用仪器按一定的程序，给神经末梢剌激，再通过计算机记录分作者单位：200025